SU1698788A1 - Method for evaluating the heparin resistance of blood - Google Patents

Abstract

This invention relates to medicine, in particular to the study of the state of hemostasis. The aim of the invention is to accelerate and simplify the method, as well as the possibility of detecting a form of heparin resistance. For this purpose, the coagulation time of the patient's blood is determined in vitro when saline solution is added to it, heparin with saline solution or heparin with factors that eliminate heparin resistance of blood to heparin, and in the absence of blood clotting time between samples containing only saline and physiological saline. heparin solution, the presence of blood heparin resistance is determined, and according to the greatest difference in blood coagulation time in a sample of heparin with a physiological solution and in a sample with heparin With the addition of factors that eliminate blood heparin resistance, labile resistance is determined. (L

Description

This invention relates to medicine, in particular to the study of the state of hemostasis.

The purpose of the invention is to accelerate and simplify the method, as well as to ensure the possibility of detecting the form of heparin resistance.

The method is carried out as follows.

A plate for immunological reactions is used for the determination. 2 drops of a physiological solution are introduced into the 1st well of the plate, 1 drop of heparin and 1 drop of physiological solution is introduced into the 2nd well. Take a pipette (from a needle inserted into the cubital vein) from the examined patient 0.3-0.5 ml of blood, and enter 4 drops in the 1st and 2nd cells. The tablet is shaken. After 2 minutes, the plate is tilted by 20-30 ° and the coagulation state is determined in the cells, then reset. This manipulation is repeated every 15-20 seconds until a clot forms in both cells. If the clotting time in both cells is almost the same, the next stage of the study is carried out: put 1 drop of cryoplasm in the 3rd cell of the plate, 4 drop - 1 drop of rubomycin hydrochloride, 5 drop - 1 drop of hydrocortisone, 6 1st drop of cryoplasm and 1 drop of heparin, on the 7th - 1 drop of hemodez. Then, 1.0-1.5 ml of blood is taken from the patient and 4 drops are introduced into each well. The tablet is shaken. Immediately thereafter, 1 drop of heparin is administered in the 3, 4, 5 and 7 cells. The tablet is re-shaken. A sample is determined in which the blood coagulated later.

Reading results: Almost equal clotting time in the 1st and 2nd cells indicates the presence of heparin resistance. The sample that caused the greatest lengthening of blood clotting time

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compared with the 2nd test, indicates the form of labile heparin resistance. The labile form of heparin resistance is considered to be the one that can be eliminated by injecting drugs into the bloodstream of the patient.

The method was applied in 28 patients with diseases of the cardiovascular system and purulent-inflammatory processes. In all 28 studied patients, in whom the first stage of the study showed the presence of heparin resistance, the second stage (determination of the form of heparin resistance) showed the greatest lengthening of the coagulation time in the cells:

a) with the addition of cryoplaema (antithrombin P) - in 19 people;

b) with the addition of heparin cryoplasm

- in 5 patients;

c) with the addition of hydrocortisone - in 2 patients;

d) with the addition of hemodez - in 1 patient;

e) with the addition of rubomycin hydrochloride - in 1 patient.

The results obtained by the method used in the prototype were identical (in patients with group a).

Example 1. Patient III ,, 55 years old, diagnosed

-adenolegmon of the lateral surface of the neck to the right. In addition to surgery, a complex anti-inflammatory therapy was prescribed, which included heparin therapy. Conducted a study on heparin resistance. The coagulation time in the 1st sample is 4 min 33 s, in the 2nd one - 4 min 38 s. Due to the absence of the effect of heparin on the blood, the second stage of the study is carried out: 1 drop of cryoplasm is introduced into the 3rd cell of the tablet, 4th to 1 drop of rubomycin hydrochloride, 5th 1 drop of hydrocortisone, to b) o - 1 drop of cryoplasm and 1 drop of heparin, in the 7th - 1 drop of hemodez. 4 drops of the patient's blood are injected into each cell. The plate is shaken and injected with 1 drop of heparin in the 3rd, 4th, 5th and 7th cells. Re-shake the tablet. The coagulation time of the cells is determined. The greatest lengthening of the coagulation time (9 min 45 s) was determined in a sample with hydrocortisone, which indicates labile heparin resistance associated with the presence of acute phase (inflammatory immune complexes) in the circulatory channel.

Example 2. Ill., 32 years old, diagnosed with septic endomyocarditis. Blood tests are performed to detect heparin resistance; 2 drops of saline are administered to the 1st well of a tablet; 2 drops of 1 drop of heparin and 1 drop are introduced into the 2nd well of the tablet.

saline solution, in the 3rd - 1 drop of cryoplasm, in the 4th - 1 drop of rubomycin hydrochloride, in the 5th - 1 drop of hydrocortisone, in the bth - 1 drop of cryoplasm and 1 drop of heparin, in the 7th - 1 a drop of gemodez, then in

4 drops of the patient's blood are injected into each cell. The tablet is shaken. After that, 1 drop of heparin is administered in 3-, 4-, 5- and 7th cells. The coagulation time of the cells is determined. Clotting time in 2nd

the cell is larger than in the 1st one, for 15 s. The greatest lengthening of the blood coagulation time (15 min 45 s) was determined in a sample containing cryoplasm. The result indicates the presence of labile heparin resistance, a decrease in the consumption of antithrombin HI, the need to introduce factors that eliminate the resistance that has arisen.

Thus, for 15 minutes of research

the presence of heparin resistance and its shape are determined.

The proposed method is effective both in determining heparin-erection before using heparin and in the period of ongoing heparin therapy, it is simple to perform, does not require special training of personnel, expensive equipment and reagents.

Claims (1)

Invention Formula A method for determining blood heparin resistance, including a study of the biochemical blood parameters of a patient, characterized in that, with the aim of speeding up and simplifying the method, as well as making it possible to detect the form of heparin resistance, the blood coagulation time in the sample is determined by adding physiological saline to it, saline heparin heparin with factors that eliminate blood heparin resistance to heparin, and in the absence of a difference in blood coagulation time between the sample containing iziologichesky solution and saline solution with heparin, determine the presence of blood heparin-eureticity, and according to the greatest difference in blood clotting time in a sample of heparin with physiological with a solution and in the sample with heparin and with the addition of factors eliminating heparin-resistant blood, labile resistance is determined.